Saturday, August 27, 2011

The Calm Before the Storm, In More Ways Than One

Tonight Derek gave me "the lip" and asked for Snapple.  Earlier, he asked for ice chips after complaining his throat hurt.  I know his throat hurts.  He hasn't been able to swallow anything for five weeks, but until he beats those infections a little more and it is determined that he can swallow without aspirating, we cannot allow him to drink.  I gave him an ice chip, but even after warning him not to swallow, he didn't listen, which resulted in a fifteen minute long coughing fit.  He got the picture and didn't try to swallow again.  Later, he only wanted Krystina to give him his ice chips because the nurse doesn't give him the chips with the same love that Krystina and I do.

Surgery was long today.  They took him by 7:30 and did not return him until after 12.  He had ortho washouts of his arm and legs (including replacing the anticiotic beads because that damn right leg is infected again), vascular surgery on the right arm, the urology team, and the trauma team trying to get the fluid from his abdomen.

Dr. Whittaker performed the vascular surgery this morning, but we do not yet have the results.

They determined that they could not risk getting out the fluid from his abdomen because of its location.  It is precariously located behind a cluster of nerves connecting the intestines and other organs and to get to it would put him at great risk.  They tried, but it was too risky.  They have a drain on his stomach and it is producing green bile.  They have not restrarted the tube feedings because he has not been able to tolerate them.  They are hoping tomorrow to restart them. 

His white count is up from 22.5 yesterday to 28.6 today, but his fever broke.  There are other possibilities as the source of the infection, so they are going to investigate them first, and do another CT scan with IV contrast this time, instead of GI contrast like last time, to see if that determines if the fluid is the source of the infection. 

The culture from the trach grew gram negative rods.  That is neither a good thing nor a bad thing at this point, just a thing, according to Dr. Perdue.  They have to wait until it grows to the next phase to see.
The blood culture from the c-line is negative so far but his blood is growing gram postive cocci bacteria and a-bacter (?? - need to find out more about this one). 

Derek is on seven different antibiotics so what the hell is with these new infections?  Today he asked me what would happen if the infections won, if he couldn't beat them, if the antibiotics didn't work.  I told him that they would switch to different antibiotics and find stronger ones that WOULD WORK!  I told him he would have to KEEP FIGHTING and that he WOULD beat them!  I could never tell him anything else or allow him to believe anything else.

Derek has this board that he points to the letters in order to tell us what he wants to say.  With the trach, he cannot speak yet.  He told Krystina tonight that he promises to get better for her.

The earthquake didn't shake the infections out of him, but maybe Hurricane Irene will!  We are battening down the hatches and preparing to the blown away tomorrow!  Hope you all stay safe and dry!  God bless you!

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